感染性腹泻患儿血清D-乳酸、MCP-1的水平与病情严重程度的相关性

Correlations of serum D-lactate and MCP-1 levels with severity of infectious diarrhea in children

摘要

目的 分析感染性腹泻患儿血清D-乳酸、单核细胞趋化因子-1(MCP-1)的水平与病情严重程度的相关性。方法 选取2020年3月至2023年6月收治于我院的感染性腹泻患儿116例作为感染性腹泻组,根据患儿疾病严重程度将其分为:轻度组(n=35)、中度组(n=52)及重度组(n=29)。同时选择116例同期体检健康的婴幼儿作为对照组。收集患儿相关临床资料并检测血清D-乳酸、MCP-1水平。采用多因素Logistic回归分析影响感染性腹泻患儿病情严重程度的因素;应用受试者特征(ROC)曲线评估血清D-乳酸和MCP-1水平对感染性腹泻患儿病情严重程度的价值。结果 感染性腹泻组血清D-乳酸、MCP-1水平显著高于对照组(t=36.174、16.588,P<0.05);轻、中及重度组血清D-乳酸、MCP-1水平依次显著升高(F=191.494、86.715,P<0.05);多因素Logistic回归分析结果显示,反复呼吸道感染、反复腹泻、D-乳酸及MCP-1高水平均为影响感染性腹泻患儿病情严重程度的危险因素,OR值及其95%CI分别为2.365(95%CI:1.808~3.093)、3.426(95%CI:1.812~6.478)、1.681(95%CI:1.147~2.464)、2.518(95%CI:1.449~4.376);ROC曲线结果显示,血清D-乳酸、MCP-1评估感染性腹泻患儿病情严重程度的曲线下面积(AUC)分别为0.799(95%CI:0.715~0.868)、0.794(95%CI:0.709~0.863),二者联合评估的AUC为0.912(95%CI:0.845~0.957),优于上述指标各自单独评估(Z=2.102、2.139,P<0.05)。结论 感染性腹泻患儿血清D-乳酸、MCP-1水平均显著升高,均是影响感染性腹泻患儿病情严重程度的危险因素,二者联合对评估病情严重程度具有一定价值。

Abstract

Objective To analyze correlations of serum D-lactate and monocyte chemoattractant protein-1 (MCP-1) levels with severity of infectious diarrhea in children. Methods 116 children with infectious diarrhea (infectious diarrhea group) who admitted to our hospital from March 2020 to June 2023 were selected as study subjects, and they were divided into three groups: mild infectious diarrhea group (n=35), moderate infectious diarrhea group (n=52) and severe infectious diarrhea group (n=29) according to severity of the disease. Other 116 healthy infants and children who received physical examination in the same period in our hospital were selected as the control group. The clinical data of the children were collected. Fully automatic biochemical analyzer was used to detect serum D-lactate level of the children, and enzyme-labeled antibody method [also called as enzyme-linked immunosorbant assay (ELISA)] was used to detect MCP-1 level of the children. Multiple Logistic regression was used to analyze factors affecting severity of the disease. Receiver operating characteristic (ROC) curve was applied to assess values of serum D-lactate and MCP-1 levels for severity of the disease. Results The serum levels of D-lactate and MCP-1 of the children in the infectious diarrhea group were significantly higher than those in the control group (t=36.174 and 16.588 respectively, both P<0.05). And the serum levels of D-lactate and MCP-1 were gradually significantly increased in the mild infectious diarrhea group, the moderate infectious diarrhea group and the severe infectious diarrhea group in order (F=191.494 and 86.715 respectively, both P<0.05). The multiple Logistic regression analysis showed that recurrent respiratory infection, recurrent diarrhea, and high serum levels of D-lactate and MCP-1 were all risk factors affecting the severity of the disease in children with infectious diarrhea, and their ORs (95%CI) were 2.365 (1.808-3.093), 3.426 (1.812-6.478), 1.681 (1.147-2.464) and 2.518 (1.449-4.376) respectively. The ROC curve analysis showed that the areas under the curve (AUCs) of serum D-lactate and MCP-1 for assessing the severity of the infectious diarrhea in children were 0.799 (95%CI: 0.715-0.868) and 0.794 (95%CI: 0.709-0.863), and the AUC of the combination of the two for assessing the severity of infectious diarrhea was 0.912 (95%CI: 0.845-0.957), which was superior to single D-lactate and MCP-1 alone (Z=2.102 and 2.139 respectively, both P<0.05). Conclusion Serum levels of D-lactate and MCP-1 significantly elevate in children with infectious diarrhea, both of them are risk factors affecting the severity of the disease in children with infectious diarrhea, and the combination of the two has a certain value for evaluating the severity of the disease.

关键词

感染性腹泻 / D-乳酸 / 单核细胞趋化因子-1 / 病情

Key words

infectious diarrhea / D-lactate / monocyte chemoattractant protein-1 / condition of disease

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基金资助

河北省中医药管理局科研计划项目(2021304)